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States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.

Displaying 1 - 15 of 25

Tip Sheet | June 2023
Definitions of Different Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Types in 2023 and 2025
This resource was updated in June 2023 to correct an error in the definition of applicable integrated plan in the previous version. Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use… (Integrated Care Resource Center)
Other Resource | March 2019
Three New Opportunities to Test Innovative Models of Integrated Care for Individuals Dually Eligible for Medicaid and Medicare
This State Medicaid Director Letter invites states to partner with CMS to test innovative approaches to better serve individuals who are dually eligible for Medicare and Medicaid. The three new opportunities include: capitated Financial… (Centers for Medicare & Medicaid Services)
Other Resource | December 2018
Ten Opportunities to Better Serve Individuals Dually Eligible for Medicaid and Medicare
This State Medicaid Director Letter highlights ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid. These opportunities, which do not require demonstration authority or Medicare waivers, fall into… (Centers for Medicare & Medicaid Services)
June 2017
A Questionnaire to Assess Individuals' Ability to Self-Direct Services
This questionnaire helps case managers to assess the ability of an individual to self-direct services, and if the individual requires assistance from a representative. (Integrated Care Resource Center)
Technical Assistance Tool | June 2017
Roles and Responsibilities in a Self-Direction Program
This tool gives examples of the roles and responsibilities of the individual, representative, case manager, information and assistance function, the financial management services function, and the direct care worker. (Integrated Care Resource Center)
June 2017
Representatives' Responsibilities in a Self-Direction Program
This document describes the purpose and qualifications of representatives. (Integrated Care Resource Center)
June 2017
Policies and Procedures Manual Topics for a Self-Direction Program
This resource suggests topics to be covered in a policies and procedures manual for the day-to-day management of the self-direction program. Programs should add topics as needed to ensure efficient and consistent program operations. (Integrated Care Resource Center)
June 2017
Permissible Goods and Services in a Self-Direction Program
This document offers the Centers for Medicare & Medicaid Services' (CMS) guidelines for permissible goods and services, and can be customized to include additional state guidelines. (Integrated Care Resource Center)
June 2017
Individuals' Rights and Responsibilities in a Self-Direction Program
This document reviews the individual's rights under the self-directed option as well as his or her associated responsibilities for participation. (Integrated Care Resource Center)
Tip Sheet | June 2017
Four Steps for Managed Care Plans to Promote Person-Centered Planning in Self-Direction Models
This tip sheet suggests steps that managed care plans can take to ensure that case managers are effectively trained on approaches to promote person-centered planning in self-directed delivery models for home- and community-based services. (Integrated Care Resource Center)
June 2017
A Questionnaire to Assess Potential Representatives in Self-Direction Programs
This questionnaire helps individuals and health plan case managers to select an appropriate person to be informally designated as a representative decision-maker. (Integrated Care Resource Center)
Tip Sheet | June 2017
Tips for States to Advance Person-Centered Planning in Self-Direction Models
This tip sheet offers suggestions for states operating managed long-term services and supports programs or other managed integrated care programs to: (1) understand the person-centered planning process; (2) establish robust contract requirements and… (Integrated Care Resource Center)
June 2017
Frequently Asked Questions about Self-Direction
This document answers common questions about self-direction including: (1) what is self-direction and why is it an important option for individuals receiving HCBS; (2) what are the components of self-direction. The document also defines self-… (Integrated Care Resource Center)
June 2017
Person-Centered and Participant-Directed Services: Implications for Practice
This video describes one social worker's approach to person-centered planning and explanation of self-direction. (Integrated Care Resource Center)
June 2017
Facilitator's Guide
This document accompanies the video and provides questions to help health plan case managers examine their impressions and opinions of what they have watched in the video. (Integrated Care Resource Center)